PURPOSE: To report a case with refractory tamoxifen-induced keratopathy despite drug withdrawal. METHODS: Case report. RESULTS: A 50-year-old woman, diagnosed with bilateral breast cancer underwent mastectomy in 2005. She was treated with tamoxifen citrate from 2005 to 2012. According to her medical history, no corneal abnormalities had been documented during past ophthalmological examinations except low myopia, before initiation of tamoxifen treatment...

PURPOSE: To compare outcomes of Descemet stripping automated endothelial keratoplasty (DSAEK) and Descemet membrane endothelial keratoplasty (DMEK) when an experienced DSAEK surgeon transitions to DMEK while following 2 published endothelial keratoplasty surgical techniques. METHODS: This is a retrospective review of 200 eyes of 132 patients with Fuchs corneal dystrophy that underwent endothelial keratoplasty performed by one surgeon. Published, standardized techniques were followed for both DSAEK and DMEK...

PURPOSE: To review ethical issues that may arise in the setting of transnational eye banking activities, such as when exporting or importing corneal tissue for transplantation. METHODS: A principle-based normative analysis of potential common dilemmas in transnational eye banking activities was performed. RESULTS: Transnational activities in eye banking, like those in other fields involving procurement and use of medical products of human origin, may present a number of ethical issues for policy makers and professionals...

PURPOSE: To evaluate outcomes of Descemet membrane endothelial keratoplasty (DMEK) in eyes with previous trabeculectomy or a drainage device. METHODS: This is a retrospective study of 108 consecutive DMEK performed between October 2013 and December 2015. All eyes were divided into 3 groups: surgical treatment (ST) group, medical treatment (MT) group, and control group. Visual improvement, endothelial cell loss, and postoperative complications, including rejection, graft failure, and intraocular pressure elevation (≥25 mm Hg) were evaluated...

PURPOSE: For morphometric analysis of the cell mosaic of corneal endothelium, checking accuracy and precision of instrumentation is a key step. In this study, a standard reference sample is proposed, developed to reproduce the cornea with its shape and the endothelium with its intrinsic variability in the cell size. METHODS: A polystyrene bead layer (representing the endothelium) was deposited on a lens (representing the cornea). Bead diameters were 20, 25, and 30 μm (fractions in number 55%, 30%, and 15%, respectively)...

PURPOSE: Morphological features of tear microdesiccates on glass surfaces have been associated with tear fluid status. Tear-film lipids play a critical role in the pathophysiology of some ocular surface disorders. Tear microdesiccates display 4 distinctive morphological domains (zones I, II, III, and transition band). In this study, we investigated the lipid location in tear microdesiccates. METHODS: Tear from individual healthy eyes (assessed by symptoms, signs, and slit-lamp examination) was collected using absorbing minisponges...

PURPOSE: To assess intraobserver repeatability and interobserver and intersession reproducibility of lower tear meniscus height (LTMH) measurements obtained using a new anterior segment swept-source optical coherence tomography (SS-OCT) device. Agreement with Fourier-domain (FD) OCT (Spectralis) was also examined. METHODS: In an observational cross-sectional study, one eye of 29 healthy subjects was randomly imaged with both devices at our center. Two examiners then randomly measured the LTMH using the software's calipers...

PURPOSE: To report a unique case of peripheral ulcerative keratitis secondary to hepatitis B virus (HBV)-associated cryoglobulinemia and vasculitis and its pharmacological and surgical treatment and 2-year follow-up. METHODS: A 52-year-old woman presented with unilateral eye pain and photophobia, arthralgia, remnants of a maculopapular rash, and subsequently facial numbness several weeks later. Her best spectacle-corrected visual acuity (BSCVA) in the affected eye was 20/80...

PURPOSE: The aim of this study was to evaluate the effect of trabeculotomy (TLO) on glaucoma and endothelial cell loss after penetrating keratoplasty (PK). METHODS: A retrospective study was conducted on consecutive patients who underwent PK and in whom more than 24 months of follow-up was available. Patients were categorized into the PK+TLO group [ie, TLO for post-PK glaucoma (n = 10)] and the PK group [PK alone (n = 73)]. Intraocular pressure (IOP) was evaluated during each follow-up examination...

PURPOSE: We report a 75-year-old woman with a history of multiple myeloma immunoglobulin D (IgD) variant, who presented with an epibulbar plasmacytoma masquerading as a subconjunctival hemorrhage. METHODS: Magnetic resonance imaging of the brain and orbits with and without contrast was obtained and surgical biopsy of the subconjunctival lesion was performed; histopathology confirmed the diagnosis of plasmacytoma. RESULTS: Subconjunctival biopsy revealed a plasma cell neoplasm infiltrate in the episcleral layer...

PURPOSE: The purpose of this study was to determine the correct concentration and duration of application of trypan blue dye to Descemet membrane endothelial keratoplasty (DMEK) donor corneal tissue before transplant to enhance visibility while minimizing damage to the tissue. METHODS: Corneas were precut for DMEK using an 8-mm punch, and each was stained with either 0.06% or 0.15% trypan blue for a duration of 1, 3, or 5 minutes. After staining, each tissue was placed in balanced salt solution and observed to determine how quickly the stain faded from the tissue using a grading system...

PURPOSE: Corneal transplantation is the treatment of choice for many corneal diseases. At present, there is a global shortage of corneal transplant tissues, and failure to obtain consent from families of potential donors is a major limiting factor in tissue procurement. METHODS: All family members of potential donors after cardiac death approached by the local eye bank staff members from January 2008 to December 2014 in Hong Kong were included. Reasons for consent or refusal and sociodemographic details of the deceased and the family members approached were reviewed...

PURPOSE: To determine recent trends in and sociodemographic/comorbid conditions associated with penetrating keratoplasty (PK) and lamellar keratoplasty (LK) for keratoconus (KCN). METHODS: Patients with KCN and subsequent PK and LK procedures were identified using International Classification of Diseases, 9th revision (ICD-9) and Current Procedural Terminology (CPT) billing codes. The change in surgical rates was calculated over a decade, and multivariate analysis demonstrated factors associated with undergoing surgery...